Gender differences in the quantitative and qualitative assessment of chronic pain among older people.

Background: Pain, regardless of its causes, is a subjective and multidimensional experience that consists of sensory, emotional and cognitive factors that cannot be adequately captured by a single number on a pain scale. The aim of the study was to understand gender differences in the assessment of quantitative and qualitative chronic pain among older people. Methods: The study used a questionnaire that included questions about demographic and social characteristics as well as the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Depression Scale (GDS-15), McGill Pain Questionnaire (MPQ). Results: The pain rating index based on rank values of adjectives was higher among women than men (18.36 ± 7.81 vs. 17.17 ± 9.69, p = 0.04). The analysis of the frequency of selection of individual adjectives describing the sensory aspects of pain showed that men described the pain as "stabbing" more often than women (26.1% vs. 14.3%, p < 0.05). Women chose adjectives from the emotional category more often than men (59.8% vs. 75.4%, p < 0.05), describing the pain as "disgusting" (8.9% vs. 1.4%, p < 0.05), "unbearable" (19.6 vs. 4.3, p < 0.05). In the subjective category, there was a difference between women and men in terms of describing pain as "terrible" (23.2% vs. 7.2%, p < 0.05) and as "unpleasant" (11.6% vs. 23.3%, p < 0 0.05). Conclusion: When referring to pain, women tend to employ more detailed and factual language, indicative of heightened emotional sensitivity. Men tend to use fewer words and focus on the sensory aspects of pain. Subjective aspects of pain were demonstrated by both women and men.

Factors Correlating with Functional Capacity in Older People with Chronic Pain.

INTRODUCTION: Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. MATERIAL AND METHODS: The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). RESULTS: In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. CONCLUSIONS: Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain's intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.

Pain measurement in the older people: evaluation of the psychometric properties of the Geriatric Pain Measure (GPM-24) - polish version.

BACKGROUND: Chronic pain in older people is of particular importance not only with regard to negative subjective experience but also as an indicator of the quality of medical care. Brief scales to assess pain may help health professionals with early recognition and treatment to avoid patient suffering. However, these scales should be adapted to the cultural context to provide valid assessments. The aim of this study was to evaluate the psychometric properties of the Polish translation of the Geriatric Pain Measure - 24 (GPM-24) in older people. METHODS: The study was conducted among 181 people aged 65 and over with chronic (noncancer) pain of varying intensity lasting more than 6 months. Construct validity was assessed using the principal component analysis (PCA) method with oblimin rotation. Criterion validity was evaluated by correlating the scores of the GPM-24 with the scores of the McGill-Melzack questionnaire (MPQ). The reliability of the GPM-24 was estimated in terms of internal consistency using Cronbach's alpha coefficients. RESULTS: The PCA revealed a 6- component structure of the set of items that constituted the GPM-24. Most of these components were defined by items included in the same subscale, similar to the result obtained by the original scale's authors. There were significant correlations between the GPM-24 and some dimensions of MPQ: affective (rho = 0.25, p = 0.001), present pain intensity (rho = 0.44, p < 0.001), pain rating index total (rho = 0.31, p < 0.001), and number of words chosen (rho = 0.26, p < 0.001). The value of the standardized Cronbach's alpha equalled 0.89 and thus confirmed the high reliability of the GPM-24. CONCLUSIONS: The Geriatric Pain Measure - 24 is a reliable and valid tool that is recommended for the monitoring and multidimensional assessment of chronic pain in older people in daily practice as well as in clinical trials. TRIAL REGISTRATION: Statutory research "Chronic pain in people over 65 years of age" K/ZDS/005733, conducted in 2015-2018.

Assessment of Functional Status and Quality of Life of Elderly Patients Undergoing Radiotherapy and Radiotherapy Combined with Chemotherapy - A Cross-Sectional Study.

BACKGROUND: Aging is associated with various diseases, a plethora of which are oncological. Selected treatment methods influence the performance status and the adaptability to changing circumstances. OBJECTIVE: The aim of the study was to assess the functional status, quality of life, and adaptation to disease of elderly patients who underwent only radiotherapy or chemotherapy combined with radiotherapy. PATIENTS AND METHODS: The cross-sectional study was conducted in a sample of 76 patients diagnosed with cancer, over 60 years of age (mean 69.3/SD 6.8) who were hospitalized in the Radiotherapy Department at the Ludwik Rydygier Hospital in Krakow. Standardized research tools were: Functional Assessment of Chronic Illness Therapy (FACIT-F), Mental Adjustment to Cancer Scale (Mini-MAC), Lawton Instrumental Activity of Daily Living (IADL), Yesavage Geriatric Depression Scale (GDS), an assessment scale of the post radiation reaction devised by Eastern Cooperative Oncology Group (ECOG). RESULTS: Most (n=37) patients were treated with a combination of radiotherapy and chemotherapy (48.6%), whereas 21 patients underwent only radiotherapy (27.6%). More than half of the respondents were male (68.4%, n = 52), whereas 24 (31.6%) were female. The assessment of the participants' performance status yielded results indicating an average level of all domains. Men performed better in terms of physical condition compared to a group of women (p=0.010). Women experienced fatigue more frequently than men (p=0.012). Patients who had received radiation therapy combined with chemotherapy achieved on average better results in functional well-being (FWB) than the patients who had undergone radiotherapy only (p=0.046). Depression had a significant impact on all spheres of functioning (p<0.001) except social/family well-being. CONCLUSION: The results pointed to the essential elements that should be taken into consideration in relation to treatment planning and providing care. Particular attention should be paid to women who suffered from depression and negative adaptation strategies that directly affect their functioning.

Selected aspects of the knowledge and practice concerning hand hygiene guidelines in the context of infection control structures in hospitals and long-term care facilities - findings of a questionnaire survey.

BACKGROUND: Hand hygiene (HH) is the simplest and the most fundamental means of hospital-acquired infection (HAI) prevention in both hospitals and long-term care facilities (LTCFs) which differ as to their structure, organization and epidemiology. The objective of this study was to evaluate the knowledge of, and attitudes towards, compliance with the HH guidelines by medical staff of LTCFs and hospitals, in the context of infection control organization. MATERIAL AND METHODS: The study was carried out among medical staff of LTCFs and hospitals using an anonymous questionnaire designed by the authors. The questionnaire was composed of 22 questions. RESULTS: Among 237 healthcare workers from LTCFs and hospitals (51.5% vs. 48.5%), the vast majority were women (97.5% vs. 94.8%), who were nurses (86.9% vs. 91.3%) with 21-30 years of experience (28.5% vs. 44.3%). The respondents, both working in hospitals and in LTCFs, declared that there was some surveillance of HAIs in their workplace - 78.8% vs. 87.8%, respectively, p = 0.082. However, the respondents from LTCFs significantly more often than those working in hospitals declared the lack of HAI registration (12.3% vs. 0.9%, p = 0.002), as well as the lack of surveillance of multidrug-resistant microorganisms (16.4% vs. 4.3%, p = 0.010). Although the knowledge of WHO HH guidelines was declared by over 90% of the respondents, only about 70% of them (with no significant difference between both types of facilities) properly indicated the 5 moments of HH. CONCLUSIONS: The results of the study indicate that the organizational conditions and practice of HH in LTCFs and hospitals present some differences. Therefore, there is a need for observational studies concerning HH in the context of the structure and organization of infection control, as they are necessary for the development and implementation of effective programs to improve the situation in this field. Med Pr. 2020;71(5):531-7.

Socio-demographic determinants of the acceptance of systemic connective tissue diseases.

INTRODUCTION: Socio-demographic forecasts indicate a stable increase in the population of elderly people, which gives rise to the need to examine the relationship between the acceptance of chronic illness and socio-demographic variables not only in terms of subjective negative emotions but also because of possible social consequences. The acceptance of a chronic disease is determined by factors related to its character including its severity and the discomfort it brings about but also by factors connected with the patient that is socio-demographic determinants. Objective: The objective of the study was to examine the relationship between socio-demographic variables and the acceptance of a chronic disease of locomotive organs. MATERIAL AND METHODS: The study was conducted in the group of 150 patients diagnosed with a systemic connective tissue disease during its stable phase. A socio-demographic questionnaire as well as a standardised Acceptance of Illness Scale (AIS) adapted by Juszczynski were applied in the study. The study was conducted in accordance with the recommendations of the Declaration of Helsinki. RESULTS: In the group of 150 patients suffering from a systemic connective tissue disease the percentage of women was higher than the percentage of men (60.7% vs. 39.3%). The indicator of the acceptance of illness in the group examined reached 24.5 ±7.5. The strongest correlation was found between the acceptance level and married probants (eta = 0.26; p = 0.01), high education (eta = 0.24; p = 0.04) and working activity (eta = 0.20; p = 0.01). CONCLUSIONS: Socio-demographic factors which determine the level of illness acceptance include age, marital status, education and the source of income. The acceptance of illness in the examined group of patients with systemic connective tissue diseases reached 24.5.

Promotion of Evidence-Based Nursing by Polish and foreign nursing organizations.

AIM: The aim of the review was to obtain information on specific activities undertaken by professional nursing organizations, in order to promote and develop Evidence-Based Nursing (EBN). RESULTS: The foreign organizations featured in the study actively promote EBN within their countries of origin. This activity is currently focused on the structural and financial measures (focused on extrinsic factors). Some organizations are lobbying governments for grants and general support, in order to further their use and development of EBN. Educational activities are still ongoing, which include the creation of the creation of new guidelines and publishing research in journals, along with the organization of periodic conferences. Polish Nurses Association was the only one not involved in any structural and financial activities.